Angioneurotic edema as a reaction to angiotensin-converting enzyme inhibitors.

While the incidence of ACEI-induced angioedema is low, ACEI use will continue to increase its frequency. Emergency physicians and otolaryngologists should play a key role in identifying patients with angioedema associated with ACEIs. Every patient with acute angioedema, especially in the region of the mouth, the tongue, and the upper airways, must be asked for medication with ACEIs. The physician must be aware of the fact that a moderate swelling can rapidly develop to a massive swelling, which requires an intubation or even a coniotomy. Thus, in any of these cases, the patient should be observed at least for 24 hours in the clinic or until the edema subsided almost completely.